News Scan for Apr 17, 2020

More DRC Ebola cases
Antibiotic use in Chinese hospitals
Polio in 2 countries

DRC reports 2 more Ebola cases in Beni 

The Democratic Republic of the Congo (DRC) has tracked two new Ebola cases, raising the outbreak's resurgence total to five cases that have emerged just as the country was poised to announce an end to an outbreak that began in August 2018.

According to Reuters, the two new cases occurred in a 43-year-old woman and a 28-year-old motorbike-taxi driver in Beni. The taxi driver is believed to have brought an Ebola patient to the hospital last week. All five of the recent cases have been in Beni, one of the hot spots of the outbreak.

Yesterday demonstrations broke out across Beni as citizens criticized the government's response to the flare-up of cases and demanded all Ebola test results be verified by laboratories in eastern Congo's main city of Goma and in the capital, Kinshasa, Reuters said.

So far, the DRC has reported 3,460 cases in the outbreak, of which 3,313 are lab-confirmed, with 2,277 deaths.
Apr 17 Reuters


Study finds rising use of antibiotics in Chinese hospitals

Antibiotic use in Chinese hospitals rose by nearly 40% from 2011 through 2018, with a troubling rise in the use of last-resort antibiotics, according to a study this week in Antimicrobial Resistance and Infection Control.

In the study, researchers from Peking University analyzed aggregated monthly antibiotic procurement records from 586 hospitals in 28 provinces. Information included the generic antibiotic name, procurement amount, dosage form, strength, route of administration, and geographic data. Antibiotic use was expressed in defined daily doses per 1,000 inhabitants per day (DID). The researchers also used the Watch, Access, and Reserve antibiotic categories established by the World Health Organization (WHO) to analyze antibiotic use.

From 2011 through 2018, total antibiotic use in China's hospitals increased by 39.6% (from 4.8 DID in 2010 to 6.7 DID in 2018). Antibiotic use was stable or moderately decreased in 13 provinces, while in the other 15 provinces it substantially increased. Cephalosporins were the most consumed antibiotics, accounting for 26.9% of the total antibiotic use (1.8 DID/6.7 DID). In 2018, antibiotics in the Access category accounted for 19.4% of the total use (1.3 DID/6.7 DID), while antibiotics in the Watch category made up the largest proportion—71.6% (4.8 DID/6.7 DID). The most important relative increase observed during the study period was in the use of carbapenems (233%, from 0.03 DID to 0.1 DID).

Population-weighted antibiotic use was greater in secondary hospitals than in tertiary hospitals (7.3 DID vs 6.6 DID). The use of oral antibiotics was almost twice as high as parenteral antibiotic use in secondary hospitals, whereas in tertiary hospitals the amounts were about the same.

The authors of the study note that the results show that antibiotic consumption in Chinese hospitals is more than triple the average level of antibiotic consumption in 24 European Union/European Economic Area countries (2.0 DID in 2017). The increase comes despite efforts by the Chinese government to limit antibiotic use.

"The increase of antibiotic utilisation, especially the increase of last-resort antibiotics raises serious concern for public health," they wrote. "Current patterns of antibiotic utilisation demonstrated that gaps are existed towards the global target set up by the WHO. To better facilitate proper antibiotic use, more efforts are needed to explore the appropriateness of antibiotic use at the individual level."
Apr 15 Antimicrob Resist Infect Control study


Pakistan and Niger report new polio cases

Pakistan and Niger reported new polio cases this week, according to the latest weekly update from the Global Polio Eradication Initiative (GPEI).

In Pakistan, health officials identified three more wild poliovirus type 1 (WPV1) cases, raising the country's total for the year to 39. The new cases are from three different provinces: Khyber Pakhtunkhwa, the Federally Administered Tribal Areas, and Sindh.

Elsewhere, Niger reported another circulating vaccine-derived poliovirus type 2 (cVDPV2) case, which appears to be the first of the year, based on GPEI background materials, though no other details about the new case were available.
Apr 16 GPEI update

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